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Multiple oral candida infections in patients with Sjogren's syndrome - prevalence and clinical and drug susceptibility profiles
Journal of Rheumatology, 08/19/2011
Clinical Article
Yan Z et al. – Patients with primary SS carry a high risk of oral candidiasis and a high frequency of multiple Candida infections. The azole resistance patterns of Candida spp. support the necessity for drug susceptibility testing as a routine procedure for patients with oral Candida infections.
Methods- 30 patients with primary SS enrolled
- Diagnosis of oral candidiasis was based on the clinical manifestation, and confirmed by concentrated rinse culture
- Candida spp. assessment accomplished using standard methods: Sabouraud dextrose agar with 50 mg/l chloramphenicol and CHROMagar were used for rapid screening of clinical species, followed by the API 20C system for further species identification
- In vitro antifungal drug susceptibility of Candida isolates determined by minimal inhibitory concentrations
- 87% (26/30) of subjects had oral candidiasis, in which 42% (11/26) had multiple Candida spp. infection
- Although C. albicans remains predominant isolate, other rare species such as C. tropicalis, C. glabrata, C. parapsilosis, and C. krusei were present, alone or in combination
- Chronic atrophic candidiasis is the most common clinical type of oral candidiasis in patients with SS
- Susceptibilities of 44 Candida isolates to 7 antifungal agents varied dramatically
- Resistance to azoles was remarkable, and the phenomenon of cross-resistance between itraconazole and fluconazole was observed
